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Vaccine Exemptions Back in Spotlight After Measles Outbreak

Fifty-one cases of the measles can be traced to the patients' recent visits to Disneyland, California public health officials said this week.

The quick spread of the preventable illness has once again shined a spotlight on families who opt their children out of vaccines required for school attendance and on the public policies that allow them to claim unspecified personal or philosophical exemptions from those requirements.

"Measles is a respiratory disease caused by a virus and spread through the air, according to the Centers for Disease Control and Prevention. Measles starts with a fever, runny nose, cough, red eyes and sore throat, the CDC said.

The disease outbreak apparently surfaced when visitors reported coming down with measles after visiting the park December 15-20.

For the most part, it spreads among those who have not been vaccinated against the virus. Overall, 82% of those infected in this outbreak were not vaccinated, either because they're too young or because they elected not to be, officials said."

"All states require a schedule of vaccines that a child must have before he or she can be enrolled in school. Every state allows exemptions from vaccines for medical reasons, and all but Mississippi and West Virginia allow exemptions for religious reasons, according to the Centers for Disease Control and Prevention in Atlanta.

Public health experts find the most fault with personal exemptions, also known as philosophical exemptions, which are in place in 19 states. Those exemptions typically allow parents to opt out of vaccinating their children by signing a one-time form and without disclosing a reason.

And the number of parents claiming such exemptions has grown over the last decade, with high concentrations of exemptions in states with especially permissive policies."

Further complicating the problem, new research published this week in the journal Pediatrics says that families who opt out of vaccines tend to cluster in certain areas, increasing their already vulnerable children's likelihood of getting sick. Researchers studied children in a group of northern California counties born between 2000 and 2011 who did not receive all or a portion of required vaccines.

"Five hot spots stood out, including a 1.8-mile area in Vallejo, where 22.7 percent of kids were under-vaccinated," said an NPR story on the study. "More than 10,000 toddlers lived within the five clusters."

So what can states do?

In addition to eliminating loopholes that allow families to opt out of vaccines, states are also upping pre-requisites to waive the requirements.

In May I wrote of a new Colorado law that requires schools to track vaccination rates to report them to parents if they request them. That law was a compromise; an earlier version would have also required parents to complete an online education module about vaccines before claiming an exemption.

Other states have successfully passed measures to require such "informed exemptions."

In 2011, Washington passed a bill requiring parents to obtain a doctor's signature before claiming a personal exemption. In 2012, California passed a similar law. A 2013 Oregon law requires parents to obtain a doctor's signature or complete an online education module before claiming a personal exemption.

Under a new Michigan law that went into effect Jan. 1, parents in the Wolverine State must complete an educational session and sign a waiver "which acknowledges they understand the risks and benefits of vaccines as well as the possible consequences of forgoing vaccinations," according to this story from the Grand Rapids Press.

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